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Ann Thorac Surg 2009;87:1266-1268. doi:10.1016/j.athoracsur.2008.08.037
© 2009 The Society of Thoracic Surgeons
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Case Reports

Bronchoscopic Blood Injection Reducing Lung Volume in Lymphangioleiomyomatosis

Soichiro Kanoh, MD, Hideo Kobayashi, MD*, Kazuo Motoyoshi, MD

Division of Respiratory Medicine, Department of Medicine, National Defense Medical College, Tokorozawa, Saitama, Japan

Accepted for publication August 18, 2008.

* Address correspondence to Dr Kobayashi, Division of Respiratory Medicine, Department of Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan (Email: kobahide{at}ndmc.ac.jp).

Bronchoscopic lung-volume reduction for hyperinflated air-trapping disease is currently being investigated. A 41-year-old woman with pulmonary lymphangioleiomyomatosis presented with exertional dyspnea. A chest computed tomographic scan showed hyperinflation with diffuse cystic lesions throughout both lung fields. To reduce lung volume, transbronchial autologous blood was followed by thrombin solution, which was infused into cystic areas under fluoroscopic guidance. A post-treatment computed tomographic scan showed volume reduction corresponding to decreased total lung capacity by 240 mL on body plethysmography. Dyspnea was significantly improved. Bronchoscopic treatment by blood infusion is less invasive and appears clinically valuable, potentially providing therapeutic benefit in hyperinflated lung diseases such as lymphangioleiomyomatosis.






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